Provider Demographics
NPI:1053409250
Name:AMEDISYS HOME HEALTH, INC. OF VIRGINIA
Entity type:Organization
Organization Name:AMEDISYS HOME HEALTH, INC. OF VIRGINIA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:LABORDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-292-2031
Mailing Address - Street 1:5959 SOUTH SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:225-292-2031
Mailing Address - Fax:225-295-9678
Practice Address - Street 1:7516 RIGHT FLANK RD
Practice Address - Street 2:SUITE 210
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-3827
Practice Address - Country:US
Practice Address - Phone:804-560-7002
Practice Address - Fax:804-569-7022
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMEDISYS HOME HEALTH, INC. OF VIRGINIA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-11
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010236983Medicaid
VA010236983Medicaid